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Black Diamond Therapeutics (BDTX)

Filed: 29 Nov 21, 9:23pm
SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Ni Fang

(Last) (First) (Middle)
C/O BLACK DIAMOND THERAPEUTICS, INC.
ONE MAIN STREET, 10TH FLOOR

(Street)
CAMBRIDGE MA 02142

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/18/2021
3. Issuer Name and Ticker or Trading Symbol
Black Diamond Therapeutics, Inc. [ BDTX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
See Remarks
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 44,026(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) (2) 08/11/2030 Common Stock 120,000 29.87 D
Stock Option (Right to Buy) (3) 02/16/2031 Common Stock 55,000 28.69 D
Explanation of Responses:
1. Includes 21,000 Restricted Stock Units ("RSUs") granted under the Black Diamond Therapeutics, Inc. 2020 Stock Option and Incentive Plan. Each RSU represents the contingent right to receive one share of the Issuer's common stock. The RSUs shall vest in three equal annual installments with the first installment commencing on August 3, 2021, the one-year anniversary of the "vesting commencement date," subject to the Reporting Person's continuous service to the Issuer through each vesting date.
2. 25% of the shares subject to this option vested and became exercisable on August 3, 2021, with the remainder vesting in 36 equal monthly installments thereafter.
3. 25% of the shares subject to this option shall vest and become exercisable on February 17, 2022, with the remainder vesting in 36 equal monthly installments thereafter.
Remarks:
Officer Title: Chief Business Officer and interim Chief Financial Officer
/s/ Brent Hatzis-Schoch, Attorney-in-Fact 11/29/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.